The development of the Brain Injury Screening Index (BISI): A self-report measure.

The aim of this study was to investigate the psychometric properties and screening accuracy of the Brain Injury Screening Index (BISI), a self-report questionnaire designed to identify a history of acquired brain injury. The study was conducted in a closed male prison in the UK. The purposive sample comprised 55 male prisoners who arrived at the establishment during the study. A repeated measures design was used, where the Brain Injury Screening Index (BISI) was administered on three occasions. Inter-rater reliability was poor to moderate, but test retest reliability was moderate to good. Medical records were not available for all participants, but the limited number obtained resulted in a sensitivity of .38 to .71 and specificity of .47 to .70 across the three screening administrations of the BISI. The limitations of the present findings are discussed in the context of the use of the tool in custodial environments. It is argued that these results suggest that, when used as recommended, the BISI has acceptable reliability and validity as an initial screen for identifying individuals who should receive support and a comprehensive neuropsychological assessment, and it merits further investigation and development.

Brain Injury and Offending: The Development and Field Testing of a Linkworker Intervention.

Evidence suggests that traumatic brain injury (TBI) is more prevalent amongst offender populations than in the general population, and that it can lead to aggressive behaviour while in custody and impair engagement with offender rehabilitation programmes. The aim of this study was to develop, implement, and evaluate a brain injury Linkworker approach designed to support prisoners who report a significant TBI or multiple mild TBIs. Three clinical case examples are reported to illustrate the conceptual foundations of the approach and to demonstrate the feasibility of the service. Early results showed that engagement with a Linkworker led to effective identification of key areas of intervention and resulted in better integration for prisoners while in custody and in enhancement of the outcomes of offender rehabilitation. These initial findings provide justification for wider implementation and systematic evaluation of the efficacy of this model of service.

The association between neuropsychological performance and self-reported traumatic brain injury in a sample of adult male prisoners in the UK.

This study employed a correlational and group comparison design to investigate whether self-report of traumatic brain injury (TBI) in a sample of male prisoners screened using the Brain Injury Screening Index (BISI) was associated with impaired cognitive performance on standardised questionnaires and neuropsychological tests. A total of 139 male prisoners who reported having suffered a TBI in the BISI were interviewed, and completed further questionnaires and neuropsychological assessments. Their results were compared to 50 prisoners who had no reported history of TBI. The results of the screening questionnaire correlated with responses in a follow-up interview, with self-report questionnaires of neurobehavioural disorder (.31 to .50) and neuropsychological measures (-.24 to -.45). The "TBI Index", an indicator summarising the number and severity of self-reported injuries in a single score, also correlated well with scores on formal neuropsychological tests (-.20 to -.42). Self-report of traumatic brain injury among prisoners is consistently associated with measurable neuropsychological and neurobehavioural disability. The implications of these findings for current practice in identifying and referring individuals to specialist services are considered.

The prevalence of traumatic brain injury in the homeless community in a UK city.

PRIMARY OBJECTIVE: The main aim of the study was to investigate the prevalence of traumatic brain injury in a sample of homeless individuals. RESEARCH DESIGN: The researchers employed a cross-sectional survey design and contacted 12 organizations providing services for homeless individuals across a city in the UK. METHODS AND PROCEDURES: The sample included 100 homeless participants (75 males and 25 females) who met the inclusion criteria. A matched control group (n = 100) of individuals who were not homeless was also recruited. A questionnaire was administered to all participants to elicit information relating to history of possible traumatic brain injury. MAIN OUTCOMES AND RESULTS: Results indicated that a significantly higher number of homeless participants (48%) reported a history of traumatic brain injury than control participants (21%). Of those homeless participants, 90% indicated they had sustained their first traumatic brain injury before they were homeless. CONCLUSIONS: These findings suggest that rates of traumatic brain injury are much higher among the homeless population than in the general population and that sustaining a traumatic brain injury may be a risk factor for homelessness.